Active NPI
Joseph M Audiino, P.A.
- Physician Assistant
- Port Jefferson, NY
National Provider Identifier
1487620100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 008410-1
- Practice address
- 200 Belle Terre Rd
Port Jefferson, NY 11777-1928 - Phone
- (631) 474-6000
- NPI assigned
- Feb 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 008410-1 | NY | |
| Physician Assistant | 363A00000X | 008410-1 | NY | Primary |
Addresses
Primary practice location
200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Mailing address
PO Box 826207
Philadelphia, PA 19182-6207
Phone (800) 377-8721
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00282198 | Other | RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
170 E Main St
Babylon, NY 11702-3510
Phone (631) 828-4545
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008410-1 | NY | MD | Emergency Medicine Physician |
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pain Medicine Physician
- Port Jefferson Station, NY
- NPI 1073002473
-
- Psychiatry Physician
- Port Jefferson Station, NY
- NPI 1376642371
-
- Physician Assistant
- Islip, NY
- NPI 1053486670
-
- Internal Medicine Physician
- West Islip, NY
- NPI 1124184544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193616000000",
"number": "1487620100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 826207",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191826207",
"telephone_number": "800-377-8721",
"fax_number": "304-523-2241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 BELLE TERRE RD",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117771928",
"telephone_number": "631-474-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUDIINO",
"first_name": "JOSEPH",
"middle_name": "M",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-23",
"last_updated": "2007-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "008410-1",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "008410-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00282198",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port Jefferson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.